Breast cancer is a significant public health concern globally, and early detection through screening programs can improve treatment outcomes and reduce mortality rates. However, the uptake of breast cancer screening among women in Saudi Arabia is hindered by various barriers. This systematic review and meta-analysis aimed to elucidate the barriers to breast cancer screening among women in Saudi Arabia, providing insights into the multifaceted challenges hindering screening uptake and informing tailored interventions and policy recommendations. A comprehensive literature search was conducted across electronic databases and grey literature sources to identify relevant studies on barriers to breast cancer screening in Saudi Arabia. Studies conducted between 2017 and 2023, employing diverse settings and methodologies, were included in the analysis. Data on the prevalence of barriers, family history of breast cancer, and self-reported breast examination practices were extracted and synthesized. A total of 14 studies met the inclusion criteria, encompassing diverse populations and methodologies. The included studies predominantly employed cross-sectional survey designs and targeted various populations across different regions of Saudi Arabia. The barriers to breast cancer screening were investigated, revealing concerns such as fear of discovering cancer, embarrassment due to breast-related tests, fear of pain related to clinical examination, and lack of awareness. Additionally, a substantial proportion of participants reported a family history of breast cancer, indicating a significant risk factor for the disease. Self-reported breast examination practices varied among participants, with disparities in screening behaviors observed. Our review identified fear of diagnosis, embarrassment, and lack of awareness as key barriers to breast cancer screening in Saudi Arabia. Targeted interventions, including education and improved access, are essential to address these challenges and enhance early detection efforts, reducing the burden of breast cancer.

Introduction: Cerebral palsy (CP) affects motor function development, requiring intensive rehabilitation. Virtual reality (VR) interventions show promise for improving motor learning through immersive, engaging experiences. This systematic review and meta-analysis evaluated VR effectiveness for motor function improvement in children with CP. Methods: Following PRISMA 2020 guidelines, we searched six electronic databases from inception to 15 June 2025. Included studies compared VR interventions versus control conditions in children with CP (ages 4–18 years), measuring motor function outcomes. Sixteen studies (n = 397 participants) met the inclusion criteria for qualitative synthesis. Random-effects models, subgroup analyses, and meta-regression were performed. Evidence certainty was evaluated using GRADE methodology. Results: Five randomized controlled trials with complete extractable data (N = 190 participants, 40 effect sizes) were included in the primary quantitative meta-analysis. The primary meta-analysis demonstrated moderate overall effects favoring VR interventions (standardized mean difference [SMD] = 0.41, 95% CI [0.16, 0.66], p = 0.001; I² = 74%); however, GRADE quality was rated LOW due to risk of bias and imprecision. Technology type critically moderated outcomes: robotic exoskeleton systems showed large effects (SMD = 1.00, p = 0.002), commercial gaming platforms showed small-to-moderate effects (SMD = 0.38, p = 0.013), while custom VR systems showed no significant benefit (SMD = 0.01, p = 0.905; Q = 29.00, p < 0.001). Age emerged as the strongest moderator: children (<6 years) demonstrated significant benefits (SMD = 0.98, p < 0.001), whereas school-age children (6–12 years) showed no effect (SMD = −0.01, p = 0.903; meta-regression slope = −0.236 per year, p < 0.001). Dose–response was non-linear, with optimal benefits at 30–40 intervention hours and diminishing returns beyond 50 h. VR proved superior to standard care (SMD = 0.83) but not to active intensive therapies (SMD = 0.09). The safety profile was favorable (1.3% adverse event rate, no serious events). No publication bias was detected. Conclusions: VR interventions demonstrated moderate, technology-dependent motor function improvements in children with CP, with benefits concentrated in young children using robotic systems. Evidence certainty is low, requiring further high-quality trials. Implementation should prioritize robotic VR for children with 30–40 h protocols.

Introduction: Glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs) and sodium‐glucose cotransporter‐2 inhibitors (SGLT2is) have demonstrated cardiovascular and metabolic benefits individually; however, the comparative effectiveness of combination therapy versus monotherapy in patients with metabolic dysfunction‐associated steatotic liver disease (MASLD) and type 2 diabetes mellitus (T2DM) remains incompletely characterized. Methods: We conducted three pairwise target trial emulations using the TriNetX Research Network. Adults with MASLD and T2DM initiating GLP‐1 RA plus SGLT2i combination therapy, GLP‐1 RA monotherapy, or SGLT2i monotherapy were identified. Primary outcomes were all‐cause mortality, major adverse cardiovascular events (MACE), and composite liver outcomes. Propensity score matching (PSM) (1:1) was performed for each pairwise comparison. Cox proportional hazards regression with Bayesian hierarchical bias‐effect (BHBE) correction was utilized to address residual confounding. Results: Following PSM, 42423 combination versus 42 423 GLP‐1 RA, 40349 combination versus 40 349 SGLT2i, and 51 826 GLP‐1 RA versus 51 826 SGLT2i patients were analyzed. Combination therapy significantly reduced all‐cause mortality versus SGLT2i monotherapy (hazard ratio [HR] 0.522, 95% confidence interval [CI] 0.488–0.559), with probable benefit after bias correction (corrected HR 0.655, posterior probability 92.4%; credible interval includes the null). Combination therapy demonstrated increased MACE risk versus GLP‐1 RA (HR 1.106, 95% CI 1.045–1.170), remaining significant after correction (corrected HR 1.111). Composite liver outcomes favored combination therapy versus SGLT2i (corrected HR 0.907, probability of benefit 81.9%). Conclusions: GLP‐1 RA and SGLT2i combination therapy significantly reduced mortality and liver outcomes versus SGLT2i monotherapy in MASLD with T2DM; however, increased MACE risk versus GLP‐1 RA monotherapy warrants consideration in management decisions.

Background/Objectives: Diabetic macular edema (DME) is a leading cause of vision loss in diabetic patients, with anti-vascular endothelial growth factor (anti-VEGF) therapy being the standard management. However, treatment response varies significantly among patients, necessitating predictive tools. This systematic review and meta-analysis evaluated the diagnostic accuracy of artificial intelligence (AI) models in predicting anti-VEGF treatment response in DME patients. Methods: We conducted a dedicated literature review following PRISMA 2020 guidelines, searching PubMed, Web of Science, Embase, Scopus, and Cochrane Library databases from inception up to 30 September 2025. Studies evaluating AI-based prediction models for anti-VEGF response in DME patients were included. The primary outcomes were sensitivity, specificity, and area under the receiver operating characteristic curve (AUC). A bivariate random-effects meta-analysis was performed using available diagnostic accuracy data. Results: From 3107 participants across 18 studies, six studies with 427 participants provided complete diagnostic accuracy data for meta-analysis. The pooled sensitivity was 86.4% (95% CI: 82.1–90.1%) and the specificity was 77.6% (95% CI: 72.8–82.0%). The summary AUC was 0.89 with a diagnostic odds ratio of 22.0 (95% CI: 12.8–37.9). AI models demonstrated superior performance compared to other methods in 87.5% of comparative studies. Moderate heterogeneity was observed (I² = 45.2%). Conclusions: AI models demonstrate good diagnostic accuracy for predicting anti-VEGF treatment response in DME patients, with a promising role for improving personalized management strategies and improved outcomes.

Epilepsy accounts for a large part of the global burden of neurological disorders. This review aimed to assess the demographics, clinical characteristics, and management of patients with epilepsy in Saudi Arabia based on studies published from 2018 to 2023. A systematic review was carried out using PubMed, Medline, Embase, and Cochrane Library from January 2018 to January 2023, where key terms related to the epidemiology, clinical characteristics, treatment, and management strategy of epilepsy in Saudi Arabia were used to search for related studies. All relevant articles published in this period in the English language were included, and data about authors, year of the study, sample size, study design, demographic characteristics, clinical characteristics, and treatment strategy were collected. A male preponderance, a 6-24.9% family history of epilepsy, an equal distribution of focal and tonic-clonic epilepsy, EEG abnormalities of 19.7-70%, and a higher prevalence of monotherapy regimens were the main findings of this review.

Background: Inflammatory bowel disease (IBD) represents a growing health challenge in regions undergoing socioeconomic transition. This study characterized IBD epidemiology across Gulf Cooperation Council (GCC) countries, forecasted future burden, and identified country-specific determinants to inform targeted health policy interventions. Methods: IBD data from the Global Burden of Disease study (1990–2021) were analyzed for all six GCC countries using descriptive epidemiology, temporal trend analysis, three forecasting models (Age-Period-Cohort, Joinpoint regression, Bayesian age-standardized rate modeling), and regression analyses to identify socioeconomic, environmental, gender-specific, and healthcare system factors associated with IBD burden variation. Results: Age-standardized IBD prevalence rates varied across GCC countries (28.92–42.93 per 100,000), with Qatar and the United Arab Emirates (UAE) showing the highest rates and fastest increases (967% and 898% since 1990). Kuwait uniquely demonstrated stable or slightly declining trends. Significant female predominance emerged in most countries (male ratio 0.70–0.91) with strong birth cohort effects (1970s cohorts showing 18–48% higher risk than 1950s cohorts). IBD manifested primarily as disability rather than a mortality burden. Projections indicate continued increases through 2030, potentially reaching 55–59 per 100,000 in Qatar and the UAE. Fast food outlet density, processed food imports, antibiotic consumption, and female vitamin D deficiency were the most significant modifiable risk factors. Conclusions: The GCC region faces a growing IBD epidemiological profile characterized by rising burden, female predominance, and generational differences in risk observations. Identification of modifiable determinants provides actionable targets for intervention, while country-specific projections offer a foundation for healthcare planning to address this challenge.